NR 565 PHARMACOLOGY WEEK 3 | ADVANCED PHARMACOLOGY PRACTICE QUESTIONS &
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
Hypertension - ANS ✔✔Underlying vascular dysfunction that leads to end organ damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ANS ✔✔Stage 1 HTN; preferred initial therapy
for African Americans
Mechanism of action: Diuretics - ANS ✔✔Decrease blood volume, venous pressure, and preload
Mechanism of action: Thiazide diuretics - ANS ✔✔Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ANS ✔✔Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ANS ✔✔HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ANS ✔✔Hyperglycemia, hyperuricemia, hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ANS ✔✔Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
,4 factors that influence drug selection - ANS ✔✔1. Special populations (pregnant/nursing/older
adult)
2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ANS ✔✔Block conversion of angiotensin I to II
Results in vasoconstriction
Drug of choice for DM/CKD due to renal protection
Side effects: ACEIs and ARBs - ANS ✔✔Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ANS ✔✔Moderate-severe kidney disease (monitor GFR)
Renal artery stenosis
Acute renal failure
Pregnancy category C/1st and D/2nd trimester (fetal kidney malformation + hypotension)
HTN medications to avoid in African-Americans - ANS ✔✔ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ANS ✔✔Vasodilation by blocking voltage-
gated Ca++ channels in cardiac smooth muscle and blood vessels
Inotropic effect: heart is depressed
Chronotropic effect: heart is slowed down
, Side effects: Calcium channel blockers - ANS ✔✔Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
Contraindications: Calcium channel blockers - ANS ✔✔Due to inotropic/chronotropic effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ANS ✔✔"Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ANS ✔✔Calcium channel blockers
Order HTN medications are typically prescribed - ANS ✔✔Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ANS ✔✔1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
Hypertension - ANS ✔✔Underlying vascular dysfunction that leads to end organ damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ANS ✔✔Stage 1 HTN; preferred initial therapy
for African Americans
Mechanism of action: Diuretics - ANS ✔✔Decrease blood volume, venous pressure, and preload
Mechanism of action: Thiazide diuretics - ANS ✔✔Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ANS ✔✔Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ANS ✔✔HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ANS ✔✔Hyperglycemia, hyperuricemia, hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ANS ✔✔Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
,4 factors that influence drug selection - ANS ✔✔1. Special populations (pregnant/nursing/older
adult)
2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ANS ✔✔Block conversion of angiotensin I to II
Results in vasoconstriction
Drug of choice for DM/CKD due to renal protection
Side effects: ACEIs and ARBs - ANS ✔✔Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ANS ✔✔Moderate-severe kidney disease (monitor GFR)
Renal artery stenosis
Acute renal failure
Pregnancy category C/1st and D/2nd trimester (fetal kidney malformation + hypotension)
HTN medications to avoid in African-Americans - ANS ✔✔ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ANS ✔✔Vasodilation by blocking voltage-
gated Ca++ channels in cardiac smooth muscle and blood vessels
Inotropic effect: heart is depressed
Chronotropic effect: heart is slowed down
, Side effects: Calcium channel blockers - ANS ✔✔Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
Contraindications: Calcium channel blockers - ANS ✔✔Due to inotropic/chronotropic effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ANS ✔✔"Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ANS ✔✔Calcium channel blockers
Order HTN medications are typically prescribed - ANS ✔✔Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ANS ✔✔1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
